Why Deaths of Despair Are Increasing in the US and Not Other Industrial Nations—Insights From Neuroscience and Anthropology

Why Deaths of Despair Are Increasing in the US and Not Other Industrial Nations—Insights From Neuroscience and Anthropology. Peter Sterling, Michael L. Platt. JAMA Psychiatry. 2022;79(4):368-374. February 2, 2022, doi:10.1001/jamapsychiatry.2021.4209

Abstract: The US National Academy of Sciences reports rising mortality for US adults, most steeply for White adults with a secondary education or less. The rise is largely attributable to deaths of despair (suicide and poisoning by alcohol and drugs) with strong contributions from the cardiovascular effects of rising obesity. Although the report does acknowledge a crisis, it proposes mild measures to manage it, such as strengthening programs to support recovery, prevent relapse, increase resilience, and perform more research toward clinically useful definitions of despair. The US National Academy of Sciences report notes that mortality is decreasing in a control group of 16 wealthy nations (including countries in Western Europe, Canada, Australia, and Japan), but it does not ask what protects those nations from despair. It has been observed that human beings are constrained by evolutionary strategy (ie, huge brain, prolonged physical and emotional dependence, education beyond adolescence for professional skills, and extended adult learning) to require communal support at all stages of the life cycle. Without support, difficulties accumulate until there seems to be no way forward. The 16 wealthy nations provide communal assistance at every stage, thus facilitating diverse paths forward and protecting individuals and families from despair. The US could solve its health crisis by adopting the best practices of the 16-nation control group.